Leishmania (Viannia) spp. dissemination and tissue tropism in naturally infected dogs (Canis familiaris).

First evidence is presented for Leishmania (Viannia) spp. dissemination and tissue tropism in the domestic dog. Using PCR and histology, parasites were detected in the conjunctiva, lung, lymph nodes and ovaries of 2 naturally infected Peruvian dogs. The detection of parasites in the blood indicates that parasite dissemination to those organs may have been haematogenous

The utility of pulse volume waveforms in the identification of lower limb arterial insufficiency

Background: The ankle brachial index is widely used for non-invasive assessment of lower limb arterial status, but has recognised limitations. The most significant limitation involves arterial calcification, which results in artefactually raised occlusion pressures and uninformative ankle brachial indices. Hypothesis: Analysis of the pulse volume waveform is useful for identification of lower limb arterial insufficiency in the presence of arterial calcification. Method: Individuals (n = 1101) registered at a Welsh general practice were invited to undergo cardiovascular risk assessment. The ankle brachial index was measured using an automated device utilising volume plethysmography and the traditional Doppler ultrasound method. Results: Eight percent of participants (30/368) had an ankle brachial index *1.3, suggesting possible arterial calcification; consideration of the pulse volume waveform in these cases identified possible mild peripheral arterial disease in three cases (10%). Furthermore, in one case, the ankle brachial indices were within the normal range, but the pulse volume waveforms suggested a moderate degree of arterial insufficiency; this participant was subsequently diagnosed with bilateral superficial femoral artery stenoses and treated accordingly. Conclusion: Pulse volume waveforms can be easily utilised as an adjunct to ankle brachial index measurement to identify patients who may benefit from further vascular assessment and interventio

Adequacy of clinical information in X-ray referrals for traumatic ankle injury with reference to the Ottawa Ankle Rules-a retrospective clinical audit

Study Objective To assess the adequacy of clinical information with reference to the Ottawa Ankle Rules (OAR) in X-ray referrals for adults with traumatic ankle injury in the ED of a South Australian tertiary hospital and report upon referring trends between emergency department clinicians. Methods A retrospective clinical audit of adult ankle X-ray referrals in the emergency department was conducted. Eligible referrals were screened for their adherence to the OAR, patient details, clinical history and referrer. A logistic regression was used to determine the influence of these factors on the likelihood of being referred for X-rays despite not meeting the OAR criteria. Sensitivity, specificity, positive and negative likelihood ratios and their associated confidence intervals were calculated to assess the diagnostic accuracy of the OAR for those referred. Results Out of the 262 eligible referrals, 163 were deemed to have met the criteria for the OAR. Physiotherapists showed the highest OAR compliance of 77.3% and were the most accurate in their use of the rules, with a sensitivity of 0.86. Medical officers, registrars and interns were 2.5 times more likely to still refer a patient for X-ray if they did not meet the OAR criteria, compared to physiotherapists as the baseline. Patient age, duration of injury etc. were not significantly associated with likelihood of referral (even when they did not meet OAR criteria). The overall sensitivity, specificity, positive and negative likelihood ratios of the OAR were 0.59 (95% CI [0.47–0.71]), 0.37 (95% CI [0.30–0.44]), 0.93 (95% CI [0.76–1.16]) and 1.10 (95% CI [0.82–1.48]) respectively. Conclusion The results of this audit demonstrated poor sensitivity and moderate compliance by referrers with the rule. Reasonable evidence exists for the implementation of individual and/or institutional-based change strategies to improve clinician compliance and accuracy with use of the OAR

Using mixed methods evaluation to assess the feasibility of online clinical training in evidence based interventions : a case study of cognitive behavioural treatment for low back pain

Background: Cognitive behavioural (CB) approaches are effective in the management of non-specific low back pain (LBP). We developed the CB Back Skills Training programme (BeST) and previously provided evidence of clinical and cost effectiveness in a large pragmatic trial. However, practice change is challenged by a lack of treatment guidance and training for clinicians. We aimed to explore the feasibility and acceptability of an online programme (iBeST) for providing training in a CB approach. Methods: This mixed methods study comprised an individually randomised controlled trial of 35 physiotherapists and an interview study of 8 physiotherapists. Participants were recruited from 8 National Health Service departments in England and allocated by a computer generated randomisation list to receive iBeST (n = 16) or a face-to-face workshop (n = 19). Knowledge (of a CB approach), clinical skills (unblinded assessment of CB skills in practice), self-efficacy (reported confidence in using new skills), attitudes (towards LBP management), and satisfaction were assessed after training. Engagement with iBeST was assessed with user analytics. Interviews explored acceptability and experiences with iBeST. Data sets were analysed independently and jointly interpreted. Results: Fifteen (94 %) participants in the iBeST group and 16 (84 %) participants in the workshop group provided data immediately after training. We observed similar scores on knowledge (MD (95 % CI): 0.97 (−1.33, 3.26)), and self-efficacy to deliver the majority of the programme (MD (95 % CI) 0.25 (−1.7; 0.7)). However, the workshop group showed greater reduction in biomedical attitudes to LBP management (MD (95 % CI): −7.43 (−10.97, −3.89)). Clinical skills were assessed in 5 (33 %) iBeST participants and 7 (38 %) workshop participants within 6 months of training and were similar between groups (MD (95 % CI): 0.17(−0.2; 0.54)). Interviews highlighted that while initially sceptical, participants found iBeST acceptable. A number of strategies were identified to enhance future versions of iBeST such as including more skills practice. Conclusions: Combined quantitative and qualitative data indicated that online training was an acceptable and promising method for providing training in an evidence based complex intervention. With future enhancement, the potential reach of this training method may facilitate evidence-based practice through large scale upskilling of the workforce

Allosteric targeting of the Fanconi anemia ubiquitin-conjugating enzyme Ube2T by fragment screening

Ube2T is the E2 ubiquitin-conjugating enzyme of the Fanconi anemia DNA repair pathway and it is overexpressed in several cancers, representing an attractive target for the development of inhibitors. Despite the extensive efforts in targeting the ubiquitin system, very few E2 binders have currently been discovered. Herein we report the identification of a new allosteric pocket on Ube2T through a fragment screening using biophysical methods. Several fragments binding to this site inhibit ubiquitin conjugation in vitro

Diffusion bonding of TiC or TiB reinforced Ti–6Al–4V matrix composites to conventional Ti–6Al–4V alloy

The diffusion bonding of conventional alloy Ti–6Al–4V (Ti-64) and composites of this alloy with 10% of TiC or TiB fabricated using blended elemental powder metallurgy was successfully carried out at 850–1000°C, with a holding time of 60 min under 0.7–1.5 MPa pressure. The metallographic and electron backscattered diffraction studies as well as the bending and microhardness tests across the bonds are presented as the evidence of joint integrity. The selected experimental parameters do not cause undesirable structural changes (degradation) in the base metals adjacent to the bond interface. Particle reinforcement at ∼10% did not appear to modify bonding parameters when compared to the unreinforced Ti-64 alloy

The utility of pulse volume waveforms in the identification of lower limb arterial insufficiency

Background: The ankle brachial index is widely used for non-invasive assessment of lower limb arterial status, but has recognised limitations. The most significant limitation involves arterial calcification, which results in artefactually raised occlusion pressures and uninformative ankle brachial indices. Hypothesis: Analysis of the pulse volume waveform is useful for identification of lower limb arterial insufficiency in the presence of arterial calcification. Method: Individuals (n = 1101) registered at a Welsh general practice were invited to undergo cardiovascular risk assessment. The ankle brachial index was measured using an automated device utilising volume plethysmography and the traditional Doppler ultrasound method. Results: Eight percent of participants (30/368) had an ankle brachial index *1.3, suggesting possible arterial calcification; consideration of the pulse volume waveform in these cases identified possible mild peripheral arterial disease in three cases (10%). Furthermore, in one case, the ankle brachial indices were within the normal range, but the pulse volume waveforms suggested a moderate degree of arterial insufficiency; this participant was subsequently diagnosed with bilateral superficial femoral artery stenoses and treated accordingly. Conclusion: Pulse volume waveforms can be easily utilised as an adjunct to ankle brachial index measurement to identify patients who may benefit from further vascular assessment and interventio

Quantum Loop Subalgebra and Eigenvectors of the Superintegrable Chiral Potts Transfer Matrices

It has been shown in earlier works that for Q=0 and L a multiple of N, the ground state sector eigenspace of the superintegrable tau_2(t_q) model is highly degenerate and is generated by a quantum loop algebra L(sl_2). Furthermore, this loop algebra can be decomposed into r=(N-1)L/N simple sl_2 algebras. For Q not equal 0, we shall show here that the corresponding eigenspace of tau_2(t_q) is still highly degenerate, but splits into two spaces, each containing 2^{r-1} independent eigenvectors. The generators for the sl_2 subalgebras, and also for the quantum loop subalgebra, are given generalizing those in the Q=0 case. However, the Serre relations for the generators of the loop subalgebra are only proven for some states, tested on small systems and conjectured otherwise. Assuming their validity we construct the eigenvectors of the Q not equal 0 ground state sectors for the transfer matrix of the superintegrable chiral Potts model.Comment: LaTeX 2E document, using iopart.cls with iopams packages. 28 pages, uses eufb10 and eurm10 fonts. Typeset twice! Version 2: Details added, improvements and minor corrections made, erratum to paper 2 included. Version 3: Small paragraph added in introductio

The impact of age and psychosocial factors on cognitive and auditory outcomes during the COVID-19 pandemic

Purpose: In March 2020, the UK government announced that people should isolate to reduce the spread of the virus that causes COVID-19. Outside a pandemic, psychosocial factors, such as socialisation and mental health, may impact the relationship between hearing loss and increased dementia risk. We aim to report the impact of psychosocial factors, including social isolation, depression, and engagement in activities, on hearing and cognitive function in younger and older adults during the COVID-19 pandemic. Method: An online survey and experiment assessed self-reported psychosocial factors, self-reported hearing ability and speech-in-noise perception, and cognition. Data were collected between June 2020 and February 2021. Older (N = 112, MAGE = 70.08) and younger (N = 121, MAGE = 20.52) monolingual speakers of English, without any language or neurological disorders participated. Multiple linear regression models were employed to investigate hypothesised associations between psychosocial factors, and hearing and cognition, in older and younger adults. Results: Multiple regression analyses indicated that older adults displayed poorer speech-in-noise perception and poorer performance on one of four cognitive tasks, compared to younger adults; and increased depression was associated with poorer subjective hearing. Other psychosocial factors did not significantly predict hearing or cognitive function. Conclusions: Data suggest that self-reported hearing and depression are related. This conclusion is important for understanding the associations between hearing loss and cognitive decline in the long-term, as both hearing loss and depression are risk factors for dementia